


You Are John Wick's Veterinarian

by rokhal



Category: John Wick (Movies)
Genre: Angst, Autism Spectrum, Death, Euthanasia, Gen, Medicine, Old Age, POV Second Person, Self-Insert, Sick Character, Veterinary Medicine
Language: English
Status: Completed
Published: 2017-06-25
Updated: 2017-06-25
Packaged: 2018-11-18 23:00:52
Rating: Teen And Up Audiences
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 2,724
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/11300631
Author URL: https://archiveofourown.org/users/rokhal/pseuds/rokhal
Summary: It's time.





	You Are John Wick's Veterinarian

Pet Name: Blue            Owner: John Smith

Date of Birth: 01/01/2010

Breed: Am. Staff.        Sex: Neutered Male

 

Complaint: Check over

 

“Check over.” You hate when the clients get cagey with reception.

You enter the small exam room and shut yourself in.

John Smith is a dour, narrow-faced middle-aged man sitting erect on the hard bench. You get the sense he would prefer to stand, straight and intent, except his hand is occupied rubbing the ears of the dull and shrunken blue pit bull sitting at his feet.

“I'm Doctor .........,” you say. He nods. “This is Blue?” He does not indulge this with a response.

Blue's hind legs are thin and he sits with them stretched out before him like a human child. You note that the knee joints are thickened even on visual exam. Blue's lumbar spine juts out above withered loin muscles. The ridges of his scapulae show, and his ribs, and the thoracic spine, and even the wings of the atlas bone at the base of his skull. His temples are hollow from lost muscle.

As you survey Blue from across the table, he struggles to get his feet on stiff legs until Mr. Smith leans down and lifts him gently under his rump. Blue wobbles toward you. You detect a musty odor. His back sags in the middle and his hind legs cross over each-other as he turns. You stroke behind his ears and his tail wags half-heartedly. Once you have the measure of him, you lift up his lips and sniff. The teeth are quite clean, suspiciously clean, as though the owner has been scaling them by hand. The gums are incongruously red at the teeth, and pale elsewhere. The musty smell is strong.

This dog has lost a drastic amount of fat and muscle mass. The pallor and the peculiar oral odor point you toward kidney failure, though diabetes or a cancer stand as ready alternatives. The swaying gait suggests spinal compression, the enlarged and stiff knees advanced osteoarthritis, common failings that you attribute to the exuberant activity and insane pain tolerance of his breed. Put baldly, the dog is falling apart. You think if you are careful you can make this appointment quick.

You think, sometimes, that God should have put a warning label on you when you left the womb.

“What brings you here today?” you ask, keeping your voice soft. You stroke Blue's ears, feeling the jutting lines of his skull. He tilts his head up at you and pants.

John Smith makes a _gck_ noise in the back of his throat, and his feet shift. “His kidneys are going out,” he says. Each word drops loud and heavy, the pitch flat, like the effort of making them and stringing them into order left no energy left to give them a pleasant cadence.

You put John on the autism spectrum and make allowances for the things you don't like. You don't like his stillness. You don't like the inch-thick manila folder he thumps on the counter between you. 

You skim the contents, looking for weights and dates. You note a healthy weight of eighty pounds, approximately constant for ten years, and then a slide beginning late last summer. A urinalysis. A biochemistry panel. A prescription diet. The last exam date was five months ago, last weight seventy-two pounds.

Blue weighs sixty-three pounds today.

Very often, when clients see that medicine has no more answers for their animals, they stop seeking help from the veterinarian who was trying to treat the disease. Later, when the disease has all but won, they seek a new veterinarian for absolution and to discuss the terms of surrender.

“I can see right now he's lost a lot of muscle mass,” you say. “That makes it difficult for him to get up, change position, and do things he used to enjoy. When a dog Blue's age is frail like this, for whatever reason, he doesn't have a realistic chance to regain—” 

Mr. Smith's hand is behind your neck and he is standing across the counter from you. You feel a cold surge of adrenaline flood your spine, and freeze. He is not touching you. You didn't even see him move. 

He swings his hand away and drops it to his side. You, belated, jerk away from where it had been and upset a box of tissues and a canister of cotton swabs, falling into the counter with your elbow. Blue sniffs your knee.

You look up at John Smith.  _He_ should have a warning label.

“I don't want to talk quality of life,” Mr. Smith grates, apparently going to pretend he had not impulsively lunged at you, stopping an inch from your head. “I want someone to help him.”

You look down at Blue. Besides the obvious solution, you come up briefly blank. You blame it on the adrenaline. “Don't touch me.”

Mr. Smith doesn't look ashamed. He doesn't look distressed, either, but that doesn't mean anything. “I won't.”

You fall back on an old script. “What are your goals for Blue?”

He looks down. You wonder how many other veterinarians have examined Blue in the five months after his main record ended. “He needs to eat.”

“How long has his appetite been poor?”

“Two days, since he stopped eating.” 

You make a note. The jokes about doctors' handwriting are true. 

“It's been six months since his last blood work and urinalysis,” you say. “We should recheck everything. Get an idea how bad—how far it's progressed. There's a good chance I could make him _feel better—_ maybe a few days, maybe a week if we're lucky—with some fluids and some antinausea medication—” 

“Feel better,” he parrots you.

“Improve his quality of life.” Too late, you recall he really doesn't like that phrase. You don't see a reaction from him. Because you are an honest idiot, you add, “Until it stops working.”

He lowers his head and folds his hands carefully. Blue wobbles over to him and collapses against his legs, resting his bony head on his knees and getting more hair on his black trousers. He unfolds his hands and strokes Blue's head. “It's his kidneys,” he says at last. “It's  _one organ._ It's twenty-twenty-two, there are treatments for people. Transplants. Drugs. I want someone to help my dog.”

Kidney transplants in dogs are more an experimental exercise than a clinical reality—beyond that, there are ethical problems. That is not to say that there are not things to do for dogs in renal failure. You glance at the file on the counter, full of wellness exams, vaccinations, sprained toes. You recall skipping over a report of a knee surgery. “Depending on the specific problems his kidney failure is causing him, there may be medications we can use to control his signs. In addition to diet and fluids. Costs tend to run pretty high, and I'm concerned that we might not be able to improve his life enough. Once an animal runs out of functional kidney, there's not a lot we can do.”

Mr. Smith doesn't blink. “I have two hundred and forty-two thousand dollars. What can that do?”

You had been contemplating a few rounds of subcutaneous fluid injections, throwing on an ACE inhibitor, erythropoetin for the anemia, phosphate binders in the food, and getting some anabolic steroids ordered—fancy stuff, easily topping three thousand. You are not prepared for John Smith. “That can probably get Blue on hemodialysis. We can stabilize him here. Then I think you should take him to UC Davis.”

He nods.

“I'm going to take Blue into the back and we're going to collect blood and urine. We may decide to hospitalize him overnight for IV fluids. Okay?”

“Okay.” He helps Blue to stand, and points him at the door to the treatment area. You slip a leash over Blue's head and he wobbles obediently by your right side.

 

* * *

 

You don't expect to hear from John Smith again, after he paid on time, in full, in cash. But you start getting treatment summaries faxed in. An MRI report. Blood work. Weights and exam notes. His weight falls to fifty-seven pounds, stabilizes, creeps up, drops to fifty-two. Blue is on twelve different medications to manage nausea, protein loss, phosphorus load, potassium balance, and appetite stimulation. He's receiving electrostimulation and underwater treadmill therapy for spinal compression from four different herniated discs. It's fascinating.

You aren't thinking of Blue Smith when your technician directs you to a room with a walk-in euthanasia. You take the chart down, recognize it, and almost don't enter the room.

You creep in. Blue is a skeleton, lying down beside Mr. Smith's chair. There is a padded neoprene harness around his rump to assist walking. His coat is glossy over his bones, and he pants at you, the eternal pit bull grin. He smells like the ocean. Mr. Smith's trouser legs are wet.

“It's time?” you ask carefully. 

Mr. Smith nods. His hand is tight on Blue's support harness. 

“Have you ever had this done for one of your animals before?” You use this question to gauge how much hand-holding the client might need. 

“No,” he replies. You open your mouth to describe the procedure, but he interrupts you. “When the State kills by lethal injection, they suffer. I don't want my dog to suffer.”

You suppress a grimace. “The government does everything wrong. They use the wrong drugs. Their sedation is wrong and it doesn't work. They can't use doctors or nurses to administer the drugs because of their professional oaths. It drives me nuts whenever they talk about it on the radio. We're very good at it, veterinarians, because we do it all the time.” 

You look up, realize you've gone off-track. You put your professional voice back on. “We give an overdose of an anesthesia drug into a vein. There can be a burning sensation if I accidentally get it outside the vein, so I inject very carefully. Sometimes they move or make a noise when the go, the body goes on after the brain has left the building. It doesn't mean anything. If you like, I can give a tranquilizer that will make him unconscious beforehand so movements like that are less likely and I don't have to fight with him over messing with his leg.”

“He'll hold still for the injection,” Mr. Smith says. “He let them for his dialysis.” Blue turns to him, lays his head on his shoe. “My—she fought to live, even though she knew what would happen. He doesn't know. He didn't want to be in the hospital but he let them treat him to make me happy.”

_Fuck,_ you think,  _this is an anchor pet. He's grieving a person, too._ You struggle to keep your face neutral. “Are you ready today?”

“Yes.” The word is loud and harsh. Blue leans his head harder onto Mr. Smith's shoe.

“Do you want us to take care of the body for you, or do you have somewhere to bury him—” 

“I'll take him.” Beside him on the bench you see a folded blanket, and a plastic painter's tarp.

You check a box on your euthanasia form. “Sign here, please.”

He snorts. He signs  _John Smith_ neatly.

You leave, open the safe, and draw up a fat syringe of the syrupy euthanasia solution. You dilute it with tap water out of your palm, wipe the hub carefully, fix a needle with the bevel up, load your pockets with a tourniquet, bandage, spare needles. The prepared syringe goes in your breast pocket. Stethoscope over your shoulders. It is a simple and automatic series of steps, but if your hands begin to tremble, as they are threatening, you may have a problem. You hope Blue's veins haven't been too overused at UC Davis. You want it to go smoothly (you always want it to go smoothly). 

The burden falls heavy on you this time: you will be responsible for Mr. Smith's last moment with his dog. It had better be a peaceful one. It will be easier if you can ignore the weight of it. You take a deep, measured breath to steady your hands, smooth away your frustration with yourself.

Mr. Smith already has Blue on the counter, leaning over him, arms wrapped around his chest and neck. You don't like that. Owners holding their own pets for euthanasia is explicitly against all guidelines you learned in school and currently held best practices. But you don't want to distress Mr. Smith with an argument, and he appears to know what he's doing.

You wrap your tourniquet above Blue's elbow. Both his forelegs have been recently shaved from recent catheter placement, and the vein shows up readily: narrow, but straight. Tiny scabs up and down the leg mark entry sites. You wrap your hand gently around the bones, roll the vein back and forth under tough dry skin, stare until there is nothing in your mind but the path of the vein, because you want to hit it without damage on the first try. You strike smoothly with the needle. Mr. Smith braces Blue's elbow, steadying it. You draw back on the plunger, and a tiny black curl of blood blooms out of the needle hub.

Relief rolls through you. Without taking your eyes from the syringe held against Blue's leg, you loosen the tourniquet. “I'm going to give this all at once,” you say. You don't look up. You depress the plunger firmly, squeezing the viscous liquid through the fine needle, watching for any telltale thickening of a leaking vein. Half-way through, Blue takes a few rapid breaths. He lays his head down and starts to lick his lips, but his tongue goes limp halfway out the front of his mouth. 

“Oh,” says Mr. Smith.

You deliver the rest of the drug. A fine tremor runs through Blue's body, residual adrenaline. You wrap a bandage around the needle to hold the syringe in place, put on your stethoscope, and listen under each armpit, holding very still so that the hairs don't scratch the acoustic surface. The tremor rumbles like an earthquake, but the distinctive lub-dub of the heart is missing. You lift Blue's half-open eyelid. The light is gone—muscular tension around the globe of the eye maintains its turgor and makes the cornea a perfect optical curve. The tension is gone, the iris is blurred, the pupil dilates as you watch. You touch the softened surface gently and confirm the blink reflex is abolished.

You look up. Mr. Smith's face is stony; this doesn't mean anything. “He's gone,” you confirm. “If you need more time to say goodbye, you can take as long as you need—” 

Mr. Smith turns away and shakes out the blanket. You put Blue's tongue back in his mouth.

There is a technique to wrapping a body neatly in a blanket, which you learned five years ago during a euthanasia for a client from the nearby Indian Reservation. There is also a technique to wrapping the blanket neatly in a plastic tarp, which you learn today from Mr. Smith. You like it when the owners of large dogs bring blankets to take the bodies home in. The clinic provides cardboard boxes, which always sag in the middle.

He clutches the bundle in his arms—always smaller than you expect. “Thank-you,” he says.

You never know what to say to that. It's the ones who fought hardest to keep their animal alive who thank you the most for putting them down.

“You did it better than I would have,” he continues.

Well, gee, you'd fucking hope so, you've done a thousand of them. You smile awkwardly. “Take care of yourself.” You open the door.

He pauses. “I'll never get another dog.”

You look at the bundle in his arms. “It doesn't get easier,” you say. “Blue was lucky to have you.”

He looks at the floor a few seconds. “So was I.”

He leaves with a straight back, the body close to his chest. He should be proud, for doing so much for his dog. But love is not proud. Love consumes, humbles, and destroys, as those we love are taken from us, and love renews, strengthens, and gives new purpose, until at last it is our turn to be mourned.

 

**Author's Note:**

> In this fic I propose John Wick is on the autism spectrum--not out of some desire to swell the ranks of fictional autistics, but because his portrayal in the films hits so many autistic notes it must be authorial intent. John is awkward. He speaks simply and roughly. Though he is liked and respected, he has not leveraged this respect into friendships. The one person he describes as a friend, he went years without speaking to, without any damage to the relationship. He grieves deeply but quietly. Other people perceive him as special: a boogeyman to fear, a tool to use, a younger brother who needs the rules spelled out. Proposing him as autistic by no means makes him less badass--his special interest is killing people, holy shit that's terrifying. And I think his peculiarity, more than his videogame protagonist badassery, is what gives the films their heart and appeal.
> 
> About the dog's kidney failure: this is a common cause of disease in geriatrics. It is irreversible and to some degree inevitable. We should all be so lucky as to live to be a hundred years old and die of kidney failure.
> 
> About the euthanasia: this is not intended to be a model example of the procedure. This might not be how they would do it for your animal. This is how they do it in cheap clinics. And it works fine, but there is less margin for error.
> 
> If you have concerns or questions about veterinary medicine, ask a veterinarian IRL. They are not allowed to give medical advice over the Internet.


End file.
